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Intravenous Steroids

神经

关键词神经 治疗药物 临床用药

词汇介绍

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解析

intravenous    英 [,ɪntrə'viːnəs]   ['ɪntrə'vinəs] 

       adj. 静脉内的

同根词    intravenously adv. 静脉注射地;通过静脉

       Can you tell me this drug should be administered by intravenous injection or dripping? 你可以告诉我这个药是经由静脉注射还是静脉滴注吗?

 

steroids    英 ['stiərɔidz]   

        n. [生化] 类固醇(steroid的复数形式);甾体

       Neuroactive steroids 神经活性甾体;神经活性类固醇

cardiotonic steroids 强心甾类固醇;洋地黄类;强心甾体

adrenal steroids 类固醇;肾上腺甾醇

       And he did it all without steroids他没有借助类固醇便办到了。

概述

在注射外科中常用的肾上腺皮质激素是糖皮质激素,如强的松龙、氢化可的松、地塞米松等。糖皮质激素局部注射的主要作用是抗炎,其次是抗过敏及免疫抑制,此外有人认为它尚有松解粘连的作用。机理(1)减少致炎介质形成,抑制组织炎症反应,减少炎性渗出。(2)稳定溶酶体膜,减少水解酶释放。(3)降低细胞膜及毛细血管壁的通透性,以减轻组织水肿及细胞坏死。(4)抑制增生性炎症反应,阻抑和破坏结缔组织及毛细血管的增生,可预防或减轻粘连与瘢痕形成。临床应用(1)局部注射治疗血管瘤、睑板腺囊肿、骨样囊肿、鞘膜积液、瘢痕

The neurological syndromes associated with glutamic acid decarboxylase antibodies复制标题

谷氨酸脱羧酶抗体相关的神经综合征

发表时间:2019-04-08

影响因子:7.5

作者: José Fidel Baizabal-Carvallo

期刊:J AUTOIMMUN

A number of neurological syndromes have been described in patients with positive serum antibodies (Abs) against the enzyme glutamic acid decarboxylase (GAD), the rate limiting step in the synthesis of GABA (γ- aminobutyric acid). These disorders include: classical stiff-person syndrome and variants, cerebellar ataxia, limbic and extra-limbic encephalitis, nystagmus/oculomotor dysfunction, drug-resistant epilepsy, paraneoplastic stiff-person syndrome and progressive encephalopathy with rigidity and myoclonus (PERM), the latter two are mainly related to amphiphysin and the glycine receptor Abs respectively; but patients may also have positive GAD-Abs. Although observations are consistent with an autoimmune response in these patients and there is evidence of GABAergic dysfunction in some cases; the pathogenic role of GAD-Abs in the nervous system has not been clarified and it is a matter of debate. The diagnosis of these syndromes is based on clinical grounds plus the presence of GAD-Abs in serum and CSF with demonstration of intrathecal secretion. Although some presentations may be negative for GAD-Abs, such as stiff-person syndrome; positive GAD-Abs are required for the diagnosis in patients with cerebellar ataxia, encephalitis, and epilepsy. Immunotherapy is required for most patients. Intravenous immunoglobulins, oral or IV steroids and plasma exchange are considered the first line options, aimed to induce remission, but chronic immunosuppression is usually required.

译文

已经在具有针对谷氨酸脱羧酶(GAD)的血清抗体(Abs)阳性的患者中描述了许多神经综合征,谷氨酸脱羧酶是GABA(γ-氨基丁酸)合成中的限速步骤。这些疾病包括:经典僵硬综合征和变异,小脑性共济失调,边缘和边缘外脑炎,眼球震颤/动眼神经功能障碍,耐药性癫痫,副肿瘤性僵硬综合征和具有僵硬和肌阵挛的进行性脑病(PERM),后者两者主要与amphiphysin和甘氨酸受体Abs有关;但患者也可能有阳性GAD-Abs。虽然观察结果与这些患者的自身免疫反应一致,但有证据表明存在GABA能功能障碍; GAD-Abs在神经系统中的致病作用尚未阐明,这是一个有争议的问题。这些综合征的诊断基于临床原因加上血清和脑脊液中GAD-Abs的存在以及鞘内分泌的证据。虽然一些表现可能对GAD-Abs有负面影响,例如僵硬综合症;小脑性共济失调,脑炎和癫痫患者的诊断需要阳性GAD-Abs。大多数患者需要免疫疗法。静脉注射免疫球蛋白,口服或静脉注射类固醇和血浆置换被认为是第一线选择,旨在诱导缓解,但通常需要慢性免疫抑制。